About 37,000 Nigerians have lost access to HIV prevention pills in six months after the United States cut its global HIV funding.
This was revealed in the 2025 UNAIDS Global Aids Update first previewed on July 14. According to the report, the number of people on PrEP (pre-exposure prophylaxis) in Nigeria had dropped from about 43,000 in November 2024 to fewer than 6,000 by April 2025.
That represents an 85% decline in a space of about five months. The report attributed the cut to the US’ government sudden reduced support for for HIV services in early 2025.
PEPFAR, the US President’s Emergency Plan for AIDS Relief, had funded 99.9% of Nigeria’s PrEP programmes in 2021, contributing over $23 million. In 2024, it committed around $15 million. But that support stopped almost overnight.
“Those services were stopped overnight when the United States Government shifted its foreign assistance strategies,” UNAIDS said.
The result has been devastating. HIV prevention services have collapsed. Many community-led programmes have also shut down. For instance, gay men and other men who have sex with men, already at risk and underserved, have lost vital access to PrEP.
This report says that the number of gay men who accessed help dropped from close to 10,000 in October 2024 to less than 5,000 in April.
“These data show a considerable decline in both the total number of people receiving PrEP and specifically the number of gay men and other men who have sex with men receiving this preventive medicine,” the report said.
The effects of the funding cuts are global. According to the report, PrEP use reached only 3.9 million people in 2024, considerably short of the 2025 target of 21.2 million.
Africa, especially, has suffered the consequences of the sudden withdrawal of the US government. UNAIDS says external funding covers most HIV prevention in Africa. In sub-Saharan Africa, almost 80% of HIV prevention money came from outside donors.
The US had planned to give $4.3 billion to global HIV programmes in 2025 through PEPFAR. The report says the funding cuts led to clinic closures, job losses for frontline health workers and halted many efforts to prevent the spread of HIV among young women and key populations.
“HIV prevention is especially at risk,” UNAIDS said. “Prevention services for people from key populations have relied heavily on external assistance but a great deal of this support was halted in early 2025.”
UNAIDS also raised concerns that other donor countries might follow the US and cut their support. “If this happens… the goal of ending AIDS as a public health threat could be in peril.”
Between its inception in 2004 and 2023, PEPFAR contributed $7.8 billion to Nigeria’s HIV response through organisations like the National Agency for the Control of AIDS (NACA).
The funding pattern suggests that the relief programme has been the largest contributor to HIV management efforts in Nigeria since its inception in 2004. The suspension of PEPFAR would leave a $390 million funding gap in HIV response efforts in Nigeria, on an annual average.
In its effort to offset the shortfall left by the funding cuts, the federal government approved an extra N4.8 billion (about $10 million) in the 2024/2025 HIV Programme Alignment budget to buy 150,000 HIV treatment packs.
Similarly, lawmakers in the National Assembly approved an additional $200 million for the health sector in the 2025 budget to offset the bill in place of the suspended US aid.
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